METABOLIC PROFILE DRUGS

vio
Jan 7, 2020
56 min read

Updated: Feb 25, 2020

PART I Hypothalamic & Pituitary Hormones, Thyroid & Antithyroid Drugs

001. Hormones are:

a) Products of endocrine gland secretion

b) Mediators of inflammatory process

c) By-products of tissue metabolism

d) Product of exocrine gland secretion

002. Select an endocrine drug which is an amino acid derivative:

a) Insulin

b) Hydrocortisone

c) Calcitonin

d) Thyroxine

003. Select an endocrine drug which is a peptide derivative:

a) Oxitocin

b) Prednisolone

c) Nandrolone

d) Progesterone

004. Select an endocrine drug which is a steroidal derivative:

a) Gonadorelin

b) Insulin

c) Levothyroxine

d) Hydrocortisone

005. Hormone analogues are:

a) Naturally occurring substances but slightly different from hormones

b) Naturally occurring substances but less efficacious than hormones

c) Naturally occurring substances having the same structure but different pharmacological properties than hormones

d) Synthetic compounds, which resemble the naturally occurring hormones

006. Regarding the mechanism of action of hormones, indicate the FALSE statement:

a) Hormones interact with the specific receptors in the wall of the cells

b) Cyclic AMP acts as a second messenger system

c) They stimulate adenylcyclase enzyme

d) Many hormones owe their effect to primary actions on subcellular membrane.

007. Hypothalamic and pituitary hormones (and their synthetic analogs) have pharmacologic applications in three areas, EXCEPT the following:

a) As replacement therapy for hormone deficiency states

b) As drug therapy for a variety of disorders using pharmacologic doses to elicit a hormonal effect that is not present at physiologic a blood levels

c) As a diagnostic tool for performing stimulation tests to diagnose hypo- or hyperfunctional endocrine states

d) As food supplements

008. Which of the following hormones is produced by the hypothalamic gland?

a) Growth hormone-releasing hormone (GHRH)

b) Follicle-stimulating hormone (FSH)

c) Aldosterone

d) Estradiol

009. Which of the following hormones is produced by the anterior lobe of the pituitary?

a) Thyrotropin-releasing hormone (TRH)

b) Corticotropin-releasing hormone (CRH)

c) Growth hormone (somatotropin, GH)

d) Growth hormone-releasing hormone (GHRH)

010. The posterior pitutary does NOT secret:

a) Vasopressin

b) Oxytocin

c) Growth hormone

d) All of the above

011. Which of the following organs is a target for prolactin?

a) Liver

b) Adrenal cortex

c) Thyroid

d) Mammary gland

012. Which of the following organ hormones is a target for growth hormone (somatotropine, GH)?

a) Glucocorticoids

b) Insulin-like growth factors (IGF, somatomedins)

c) Triiodthyronine

d) Testosterone

013. All of the following statements about growth hormone are true, EXCEPT:

a) It may stimulate the synthesis or release of somatomedins

b) Low levels of insulin-like growth factor (IGF)-1 are associated with dwarfism

c) Hypersecretion can result in acromegaly

d) It is contraindicated in subjects with closed epiphyses

014. Correct statements about adrenocorticotropic hormone (ACTH) include all of the following, EXCEPT:

a) Endogenous ACTH is also called corticotropin

b) ACTH stimulates the synthesis of corticosteroids

c) ACTH is most useful clinically as a diagnostic tool in adrenal insufficiency

d) The oral route is the preferred rout of administration

015. The hypothalamic control exists for the thyroid gland. This consideration is:

a) True

b) False.

016. Indications of bromocriptine are following, EXCEPT:

a) Prolactin-secreting adenomas

b) Amenorrhea-Galactorrhea

c) Prolactin deficiency

d) Acromegaly

017. Currently used dopamine agonists decreasing pituitary prolactin secretion are following:

a) Bromocriptine

b) Cabergoline

c) Pergolide

d) All of the above

018. Indications of oxitocin are following:

a) Labor and augment dysfunctional labor for conditions requiring early vaginal delivery

b) Incompleted abortion

c) For control of pospartum uterine hemorrhage

d) All of the above

019. Indications of vasopressin are following:

a) Diabetes mellitus

b) Hypertension

c) Pituitary diabetes insipidus

d) Incompleted abortion

020. Vasopressin possesses the following:

a) Antidiuretic property

b) Vasodilatation property

c) Release of a thyroid hormone into the plasma

d) Diuretic property

021. Oxytocin produces the following effects:

a) It causes contraction of the uterus

b) It assists the progress of spermatozoa into the uterine cavity

c) It brings about milk ejection from the lactating mammary gland

d) All of the above

022. Vasopressin causes a pressor effect by:

a) Releasing noradrenaline from the nerve terminals

b) Releasing and activating renin-angiotensin system

c) A direct action on smooth muscles of the blood vessels

d) All of the above mechanisms

023. Which of the following statements is true

a) Hypothyroidism is a syndrome resulting from deficiency of thyroid hormones and is manifested largely by a reversible slowing down of all body functions

b) Hypothyroidism is the clinical syndrome that results when tissues are exposed to high levels of thyroid hormone

024. Which of the following hormones is produced by the thyroid gland?

a) Thyroxine

b) Thyroid-stimulating hormone

c) Thyrotropin-releasing hormone

d) Thyroglobulin.

025. Which of the following hormones is produced by the thyroid gland?

a) Thyroid-stimulating hormone

b) Thyrotropin-releasing hormone

c) Triiodothyronine

d) Thyroglobulin.

026. Thyroid stimulating hormone regulates the following:

a) Iodine uptake

b) Biosynthesis of iodothyroglobulin

c) Release of thyroid hormone into the plasma

d) All of the above.

027. Thyroid hormones produce various pharmacological effects. Indicate the wrong statement(s).

a) Decline of the basal metabolic rate in the body

b) Increase in the rate and force of contraction of the heart

c) Increase in the blood cholestrol level

d) Increase in the heat production

028. Synthesis and release of thyroid hormones are controlled by:

a) Anterior pituitary alone

b) Hypothalamus alone

c) Blood levels of thyroid hormones alone

d) All of the above

029. Thyrotrophin stimulates the following processes:

a) Concentration of iodine by thyroid follicles

b) Iodination of thyroglobulin

c) Release of thyroxine and triidothyronine

d) De-iodination of thyroid hormones.

030. The rate of secretion of thyrotropin is controlled by:

a) The amount of iodine in the thyroid gland

b) The amount of thyroid hormones in the thyroid gland

c) The concentration of thyroid hormones in blood

d) The concentration of catecholamines in blood

031. Indications of thyroid hormones are following, EXCEPT:

a) Cretinism

b) Myxoedema

c) Hashimoto's disease

d) For treatment of simple obesity

032. The common side effect of thyroid hormones is following:

a) Increases in basal metabolic rate

b) Angina pectoris

c) Tremors

d) Exopthalmos

033. Currently used antithyroid drugs include the following, EXCEPT:

a) Propylthiouracil (PTU)

b) Diatrizoate sodium (Hypaque)

c) Methimazole (Tapazole)

d) Potassium perchlorate

034. In an area where goitre is endemic, which of the following drugs is used?

a) Iodide 1 part in 100000

b) Propylthiouracil 200 mg daily

c) Methimazole 40 mg daily

d) Any of the above can be used.

035. Iodide preparations can be used in following situations, EXCEPT:

a) In thyroid disorders

b) In granulomatous lesions e.g. Syphilis

c) As an antiseptic

d) In iodism

036. Daily administration of large doses (several milligrammes) of iodides to a thyrotoxic patient causes:

a) Involution of the thyroid which reaches a maximum in two weeks

b) Increased vascularity of the thyroid gland

c) Decreased storage of the colloid in the thyroid gland

d) Thyroid gland growing firm and less vascular

037. Radioiodines (I131 and I132) is suitable for:

a) Elderly patients (over 45 years)

b) Pregnant women

c) Nursing mothers

d) Younger patients

038. Radioiodines in the body emit:

a) Mainly β radiations

b) Mainly γ radiations

c) β and γ radiations equally.

d) Do not emit any radiation, therefore, are safe

PART II Pancreatic Hormones & Antidiabetic Drugs

001. Secretory products of pancreatic β-cells are:

a) Glucagon, proglucagon

b) Insulin, C-peptide, proinsulin, islet amyloid polypeptide (IAPP)

c) Somatostatin

d) Pancreatic polypeptide (PP)

002. Insulin is:

a) A glycoprotein with a molecular weight of 6000

b) A small protein with a molecular weight of 5808 having disulphide linkage

c) A fructoolygosaccharide

d) A catecholamine

003. Insulin is a polypeptide hence:

a) It is resistant to destruction by gastric juice

b) It is destroyed by gastric juice

c) It is not a polypeptide

d) It is metabolized immediately by cellular enzymes

004. Bovine insulin is less antigenic than porcine. This consideration is:

a) True

b) False

005. Insulin causes reduction in blood sugar level by the following mechanisms, EXCEPT:

a) Increased glucose uptake in the peripheral tissue

b) Reduction of breakdown of glycogen

c) Diminished gluconeogenesis

d) Decreased glucose absorption from the gut

006. Which of the following is true for glucagon?

a) Stimulates gluconeogenesis in the liver

b) Stimulates the secretion of insulin by beta cells

c) Inhibits glucose utilization by skeletal muscle

d) Inhibits uptake of aminoacids by cells.

007. Insulin can not be administered by:

a) Oral route

b) Intravenous route

c) Subcutaneous route

d) Intramuscular route.

008. Sources of human insulin production are:

a) Recombinant DNA techniques by inserting the proinsulin gene into E. coli or yeast

b) Postmortem insulin extraction from human autopsy pancreas

c) All of the above

d) None of the above

009. The primary reason for a physician to prescribe human insulin is that:

a) It has a faster onset of action than other insulins

b) It has a shorter duration of action than other insulins

c) It can be given to patients who have an allergy to animal insulins

d) It is more effective in preventing the complications of diabetes than animal insulins

010. Correct statements about crystalline zinc (regular) insulin include all of the following, EXCEPT:

a) It can serve as replacement therapy for juvenile-onset diabetes

b) It can be administered intravenously

c) It is a short-acting insulin

d) It can be administered orally

011. Diabetic coma is treated by the administration of:

a) Lente insulin

b) Glucose

c) Crystalline insulin

d) Oral anti-diabetic drugs.

012. Sulphonylureas act by:

a) Reducing the absorption of carbohydrate from the gut

b) Increasing the uptake of glucose in peripheral tissues

c) Reducing the hepatic gluconeogenesis

d) Stimulating the beta islet cells of pancreas to produce insulin

013. Sulphonylureas are effective in totally insulin deficient patients. This consideration is:

a) True

b) False

014. Currently used second-generation sulfonylureas include the following, EXCEPT:

a) Glyburide (Glibenclamide)

b) Glipizide (Glydiazinamide)

c) Glimepiride (Amaril)

d) Tolbutamide (Orinase)

015. Currently used oral hypoglycemic thiazolidinediones include the following, EXCEPT

a) Pioglitazone (Actos)

b) Rosiglitazone (Avandia)

c) Troglitazone (Rezulin)

d) All of the above

016. Thiazolidinediones act by:

a) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues

b) Reducing the absorption of carbohydrate from the gut

c) Stimulating the beta islet cells of pancreas to produce insulin

d) All of the above

017. Currently used alpha-glucosidase inhibitors include the following, EXCEPT:

a) Pioglitazone (Actos)

b) Acarbose (Precose)

c) Miglitol (Glyset)

d) All of the above

018. Alpha-glucosidase inhibitors act by:

a) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues

b) Competitive inhibiting of intestinal alpha-ghucosidases and modulating the postprandial digestion and absorption of starch and disaccharides

c) Reducing the absorption of carbohydrate from the gut

d) Stimulating the beta islet cells of pancreas to produce insulin

019. Potency of action of

a) Miglitol is six times higher than that of acarbose

b) Acarbose is more than that of miglitol

c) Miglitol and acarbose is equal

d) Oral hypoglycemic agents depend on the severity of hyperglycemia

020. Which of the following oral hypoglycaemic drugs stimulates both synthesis and release of insulin from beta islet cells:

a) Glibenclamide

b) Phenformin

c) Buformine

d) Metformin

021. Currently used oral hypoglycemic biguanides include the following, EXCEPT:

a) Repaglinide (Prandin)

b) Metformin

c) Phenformine

d) Glipizide

022. The action of insulin is potentiated by:

a) Sulphonylureas

b) Glucagon

c) Biguanides

d) None of the above

023. Duration of action of:

a) Tolbutamide is more than that of chlorpropamide

b) Chlorpropamide is more than that of tolbutamide

c) Tolbutamide and chlorpropamide is equal

d) Oral hypoglycemic agents depend on the severity of hyperglycemia

024. Side effects of sulphonylureas are less than those of biguanides. This considerations is: a) True

b) False

025. Biguanides are used in the following conditions, EXCEPT:

a) As a supplement to sulphonylurea, where it is insufficient to give good results b) In over weight diabetics

c) To reduce insulin requirements

d) In case of hyperglycemic shock

026. Which of the following agents is/are important hormonal antagonists of insulin in the body?

a) Glucagon

b) Adrenal steroids

c) Adrenaline

d) All of the above

027. Glucagon is:

a) A glycoprotein with a molecular weight of 6000

b) A peptide – identical in all mammals – consisting of a single chain of 29 amino acids

c) A a fructoolygosaccharide

d) A small protein with a molecular weight of 5808 having disulphide linkage

028. Which of the following statements is FALSE?

a) Glucagon is synthesized in the A cells of the pancreatic islets of Langerhans.

b) Glucagon is a peptide – identical in all mammals – consisting of a single chain of 29 amino acids

c) Glucagon is extensively degraded in the liver and kidney as well as in plasma, and at its tissue receptor sites.

d) Half-life of glucagon is between 6 and 8 hours, which is similar to that of insulin

029. Glucagon can be used in the following situations, EXCEPT:

a) Severe hypoglycemia

b) Severe hyperglycemia

c) Endocrine diagnosis

d) Beta-blocker poisoning

030. Main complications of insulin therapy include the following:

a) Hypoglycemia

b) Insulin allergy

c) Lipodystrophy at an injection site

d) All of the above

PART III The Gonadal Hormones & Inhibitors

001. The major natural estrogens produced by women are following, EXCEPT:

a) Estradiol (Estradiol-17β, E2)

b) Estron (E1)

c) Ethinyl estradiol

d) Estriol (E3)

002. Which of the following statements about estrogens are True:

a) Estrogens are required for normal sexual maturation and growth of the female

b) Estrogens decrease the rate of resorption of bone

c) Estrogens enhance the coagulability of blood

d) All of the above

003. The major synthetic estrogens are following, EXCEPT:

a) Dienestrol

b) Diethylstilbestrol

c) Benzestrol

d) Estradiol

004. Which of the following statements about estrogens are True:

a) Estradiol binds strongly to an α2-globulin and albumin with lower affinity

b) Estradiol is converted by liver and other tissues to estron and estriol and their 2-hydroxylated derivatives and conjugated metabolites and excreted in the bile

c) Estrone and estriol have lower affinity for the estrogen receptors than estradiol

d) All of the above

005. Indications of synthetic estrogens are following, EXCEPT:

a) Primary hypogonadism

b) Postmenopausal hormonal therapy

c) Hormonal contraception

d) For treatment of simple obesity

006. Main complications of estrogens’ therapy include the following:

a) Postmenopausal uterine bleeding

b) Breast tenderness

c) Hyperpigmentation

d) All of the above

007. Main contraindications of estrogens’ therapy include the following:

a) Estrogen-dependent neoplasmas such as carcinoma of the endometrium or carcinoma of the breast

b) Undiagnosed genital bleeding

c) Liver disease

d) All of the above

008. Tamoxifen is:

a) Antiprogestin

b) Antiandrogen

c) Antiestrogen

d) Androgen

009. Progesterone is secreted by:

a) Ovarian follicles

b) Corpus luteum

c) Granulosa and theca cells

d) All of the above

010. The major natural progestin is:

a) Estradiol

b) Estron

c) Progesterone

d) Estriol

011. Which of the following statements about progestins is True:

a) Progesterone is rapidly absorbed following administration by any route

b) In the liver, progesterone is metabolized to pregnanediol and conjugated with glucuronic acid.

c) Significant amounts of progestins and their metabolites are excreted in the urine

d) All of the above

012. The normal ovary produces small amount of androgens, including testosterone, androstenedione, and degydroepiandrosterone. This consideration is:

a) True

b) False

013. Noncontraceptive clinical uses of progestins are following:

a) Hormone replacement therapy

b) Dysmenorrhea

c) Endometriosis

d) All of the above

014. Estrogens possess immunomodulator properties, but progestins do immunodepressant ones. Is it TRUE or FALSE?

a) True

b) False

015. Mifepristone (RU-486) is:

a) Antiprogestin

b) Antiandrogen

c) Antiestrogen

d) Androgen

016. Mifepristone (RU-486) is used as a contraceptive and abortifacient. This consideration is:

a) True

b) False

017. Actions of mifepristone (RU-486) include:

a) Inhibition of ovulation during the follicular phase by blocking hypothalamic-pituitary progesterone receptors, which suppresses midcycle gonadotropin release

b) During the luteal phase, inhibition of progesterone action on the uterus, which induces prostaglandin release from the endometrium

c) Termination of pregnancy by facilitating luteolysis, menstruation, uterine motility, softening of the cervix, and detachment of the embryo.

d) All of the above

018. All of the following statements about oral contraceptives are true, EXCEPT:

a) The “combination pill” contains both estrogen and progestin

b) Ethinyl estradiol and mestranol are commonly used in oral contraceptives

c) The “minipill” contains progestin alone

d) The “triphasic pill” contains estrogen, progestin, and luteinizing hormine (LH)

PART IV Glucocorticoid, Steroidal & Nonsteroidal Anti-Inflammatory Drugs

001. Glucocorticoids are hormonal steroids:

a) Having an important effect on intermediary metabolism, cardiovascular function, growth, and immunity

b) Having principally salt-retaining activity

c) Having androgenic or estrogenic activity

d) All of the above

002. Inflammation is:

a) A localized protective reaction of a tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes loss of function

b) A deficiency of the normal immune response.

c) A reaction resulting from an immune reaction produced by an individual's white blood cells or antibodies acting on the body's own tissues or extracellular proteins.

d) All of the above

003. An acute, transient phase, of inflammation is characterized by:

a) Local vasodilatation and increased capillary permeability (phase of damage)

b) Infiltration of leucocytes and phagocytic cells (phase of exudation)

c) Tissue degeneration and fibrosis occurrence (phase of proliferation)

d) All of the above

004. A delayed, subacute phase, of inflammation is characterized by:

a) Local vasodilatation and increased capillary permeability (phase of damage)

b) Infiltration of leucocytes and phagocytic cells (phase of exudation)

c) Tissue degeneration and fibrosis occurrence (phase of proliferation)

d) All of the above

005. A chronic, proliferative phase, of inflammation is characterized by:

a) Local vasodilatation and increased capillary permeability (phase of damage)

b) Infiltration of leucocytes and phagocytic cells (phase of exudation)

c) Tissue degeneration and fibrosis occurrence (phase of proliferation)

d) All of the above

006. The following substances are considered to be referred to as eicosanoids:

a) Prostaglandins

b) Leukotrienes

c) Thromboxanes

d) All of the above

007. Correct statements about cortisol (hydrocortisone) include all of the following, EXCEPT:

a) Cortisol is synthesized from cholesterol

b) ACTH governs cortisol secretion

c) Most cortisol is inactivated in the liver

d) The half-life of cortisol in the circulations is normally about 60-90 hours.

008. Correct statements about glucocorticoids include all of the following, EXCEPT:

a) Effects of glucocorticoids are mediated by widely distributed glucocorticoid receptors that are members of the superfamily of nuclear receptors.

b) Glucocorticoids have dose-related metabolic effects on carbohydrate, protein, and fat metabolism.

c) Glucocorticoids have pro-inflammatory effects.

d) Glucocorticoids have catabolic effects in lymphoid and connective tissue, muscle, fat, and skin.

009. Physiologic doses of glucocorticoid can result in:

a) Increased liver glycogen stores, gluconeogenesis and lipolysis

b) Maintenance of cardiovascular function (by potentiation of norepinephrine) and skeletal muscle function

c) Increased hemoglobin synthesis, resulting in elevated of red blood cell count

d) All of the above

010. Which of the following glucocorticoids is a short- to medium-acting drug?

a) Prednisolon

b) Dexamethasone

c) Triamcinolone

d) All of the above

011. Which of the following glucocorticoids is an intermediate-acting drug?

a) Cortisone

b) Triamcinolone

c) Butamethasone

d) All of the above

012. Which of the following glucocorticoids is a long-acting drug?

a) Prednisolon

b) Dexamethasone

c) Triamcinolone

d) All of the above

013. Which of the following glucocorticoids have one fluoride atom in its chemical structure? a) Prednisolon

b) Fluocinolone

c) Triamcinolone

d) All of the above

014. Which of the following glucocorticoids have two fluoride atoms in its chemical structure? a) Prednisolon

b) Dexamethasone

c) Fluocinolone

d) Triamcinolone

015. Which of the following glucocorticoids has no fluoride atoms in its chemical structure? a) Prednisolon

b) Dexamethasone

c) Fluocinolone

d) Triamcinolone

016. Anti-inflammatory effect of glucocorticoids is caused by

a) Reducing the prostaglandin and leukotriene which results from inhibition of phospholipase A2

b) Reducing macrophages migration into the site of inflammation

c) Decreasing capillary permeability

d) All of the above

017. Which of the following statements concerning the anti-inflammatory effect of glucocorticoids is TRUE?

a) Anti-inflammatory effect of glucocorticoids results from inhibition of cyclooxygenase

b) Anti-inflammatory effect of glucocorticoids results from inhibition of phospholipase A2 and reducing prostaglandin and leukotriene synthesis

c) Induction of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce prostoglandins

d) All of the above

018. Immunosupressive effect of glucocorticoids is caused by:

a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and other antigen-presenting cells

b) Suppression of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce prostoglandins

c) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis.

d) All of the above

019. Which of the following statements concerning the anti-inflammatory effect of NSAIDs are TRUE?

a) Anti-inflammatory effect of NSAIDs results from inhibition of cyclooxygenase

b) Anti-inflammatory effect of NSAIDs results from inhibition of phospholipase A2 and reducing prostaglandin and leukotriene synthesis

c) Anti-inflammatory effect of NSAIDs results from induction of cyclooxygenase II expression which results in reducing the amount of an enzyme available to produce prostoglandins

d) All of the above

020. Indication of glucocorticoids is:

a) Chronic (Addison’s disease) and acute adrenocortical insufficiency

b) Organ transplants (prevention and treatment of rejection – immunosuppression)

c) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis).

d) All of the above

021. Indications of glucocorticoids are following, EXCEPT:

a) Gastrointestinal diseases (inflammatory bowel disease)

b) Postmenopausal hormonal therapy

c) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis)

d) Skin diseases (atopic dermatitis, dermatoses, localized neurodermatitis)

022. Serious side effects of glucocorticoids include the following, EXCEPT:

a) Acute peptic ulcers

b) Iatrogenic Cushing’s syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces)

c) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)

d) Hypomania or acute psychosis

023. Serious side effects of glucocorticoids include the following:

a) Adrenal suppression

b) Insomnia, behavioral changes (primarily hypomania)

c) Rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces

d) All of the above

024. Selective COX-2 inhibitors are safer than nonselective COX-1 inhibitors but without loss of efficacy. This consideration is:

a) True

b) False

025. The constitutive COX-2 isoform tends to be homeostatic in function, while COX-1 is induced during inflammation and tends to facilitate the inflammatory response. The consideration is:

a) True

b) False

026. Which of the following property combinations is peculiar to the majority of NSAIDs?

a) Antihistaminic, antipyretic, analgesic

b) Immunodepressive, anti-inflammatory, analgesic

c) Antipyretic, analgesic, anti-inflammatory

d) Anti-inflammatory, immunodepressive, antihistaminic

027. Which of the following NSAIDs is a propionic acid derivative?

a) Ibuprofen

b) Indomethacin

c) Metamizole (Analgin)

d) Diclofenac

028. Which of the following NSAIDs is an indol derivative?

a) Ibuprofen

b) Indomethacin

c) Meclofenamic acid

d) Diclofenac

029. Which of the following NSAIDs is a pyrazolone derivative?

a) Ibuprofen

b) Indomethacin

c) Metamizole (Analgin)

d) Diclofenac

030. Which of the following NSAIDs is a fenamate derivative?

a) Phenylbutazone

b) Indomethacin

c) Meclofenamic acid

d) Diclofenac

031. Which of the following NSAIDs is an oxicam derivative?

a) Piroxicam

b) Indomethacin

c) Meclofenamic acid

d) Diclofenac

032. Which of the following NSAIDs is a selective COX-2 inhibitor?

a) Piroxicam

b) Indomethacin

c) Celecoxib

d) Diclofenac

033. Which of the following NSAIDs is a nonselective COX inhibitor

a) Piroxicam

b) Rofecoxib

c) Celecoxib

d) All of the above

034. The following statements concerning aspirin are true, EXCEPT:

a) In contrast to most other NSAIDs, aspirin irreversibly inhibits COX

b) Aspirin interferes with the chemical mediators of the kallikrein system

c) Aspirin inhibits phospholipase A2

d) Aspirin inhibits tromboxane A2 formation

035. Indication for aspirin administration are the following, EXCEPT:

a) Inflammatory conditions

b) Decreasing the incidence of transient ischemic attack, unstable angina, coronary artery thrombosis with myocardial infarction, and thrombosis after coronary artery bypass grafting

c) Relieving severe visceral pain, e.g. myocardial infarction, cancer pain condition, renal or biliary colic

d) Reducing elevated body temperature

036. Side effects of aspirin include following:

a) Gastric upset (intolerance)

b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)

c) Gastric ulcers and upper gastrointestinal bleeding

d) All of the above

037. Serious side effects of metamizole (analgin) include the following:

a) Agranulocytosis, aplastic anemia

b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)

c) Iatrogenic Cushing’s syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces)

d) All of the above

038. Side effects of indometacin include the following:

a) Abdominal pain, diarrhea, gastrointestinal hemorrhage and pancreatitis

b) Dizziness, confusion and depression

c) Trombocytopenia

d) All of the above

039. Ketoprofen is a propionic acid derivative that inhibits both cyclooxygenase (nonselectively) and lipoxygenase. This statement is:

a) True

b) False

040. Ketorolac is an NSAID that is promoted for systemic use as an anti-inflammatory, not as an analgesic drug. This statement is:

a) True

b) False

041. Which of the following drugs is a 5-lipoxygenase (5-LOG) inhibitor?

a) Ibuprofen

b) Zileuton (Zyflo)

c) Metamizole (Analgin)

d) Diclofenac

042. Which of the following drugs is a leucotreine D4 receptor (LTD4) blocker?

a) Ibuprofen

b) Zileuton (Zyflo)

c) Zafirleukast (Accolate)

d) Diclofenac

043. Which of the following drugs is a thromboxane A2 receptor (TXA2) antagonist?

a) Sulotroban

b) Zileuton (Zyflo)

c) Zafirleukast (Accolate)

d) Diclofenac

PART V Immunotropic & Antiallergic Agents

001. Immune system is the integrated body system of organs, tissues, cells, and cell products that differentiates self from nonself and neutralizes potentially pathogenic organisms or substances. This consideration is:

a) True

b) False

002. Antigen is any of various substances, including toxins, bacteria, and the cells of transplanted organs, that when introduced into the body stimulate the production of antibodies. It is also called an allergen or immunogen. This consideration is:

a) True

b) False

003. Antibody is a protein substance produced in the blood or tissues in response to a specific antigen, such as a bacterium or a toxin that destroys or weakens bacteria and neutralizes organic poisons, thus forming the basis of immunity. This consideration is:

a) True

b) False

004. Innate immunity refers to:

a) Antigen-nonspecific defense mechanisms that a host uses immediately or within several hours after exposure to an antigen. This is the immunity one is born with and is the initial response by the body to eliminate microbes and prevent infection

b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react with and remove a specific antigen. This is the immunity one develops throughout life

005. Adaptive (acquired) immunity refers to:

b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react with and remove a specific antigen. This is the immunity one develops throughout life

006. Allergic reaction is:

a) A local or generalized reaction of an organism to internal or external contact with a specific allergen to which the organism has been previously sensitized

b) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes a loss of function

007. Immediate allergy reaction (type I allergic reaction) is:

a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after exposure to an antigen to which the individual has been sensitized

b) An allergic reaction that becomes apparent only hours after contact

c) An allergic reaction that results from the formation of antigen-antibody complexes between a foreign antigen and IgM or IgG immunoglobulins. (It occurs during blood transfusion reactions and in hemolytic disease of the newborn)

d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue damage

008. Delayed allergy reaction (type IV allergic reaction) is:

a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after exposure to an antigen to which the individual has been sensitized

b) An allergic reaction that becomes apparent only hours after contact

d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue damage

009. Immunodeficiency:

a) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and sometimes a loss of function

b) A disorder or deficiency of the normal immune response

c) A disease resulting from an immune reaction produced by an individual's white blood cells or antibodies acting on the body's own tissues or extracellular proteins

d) All of the above

010. Anaphylactic shock is a severe, sometimes fatal allergic reaction characterized by a sharp drop in blood pressure, urticaria, and breathing difficulties that is caused by exposure to a foreign substance, such as a drug or bee venom, after preliminary or sensitizing exposure. This consideration is:

a) True

b) False

011. H1 histamine receptor subtype is distributed in:

a) Smooth muscle, endothelium and brain

b) Gastric mucosa, cardiac muscle, mast cells and brain

c) Presynaptically in brain, mesenteric plexus and other neurons

d) All of the above

012. H2 histamine receptor subtype is distributed in:

a) Smooth muscle, endothelium and brain

b) Gastric mucosa, cardiac muscle, mast cells and brain

c) Presynaptically in brain, mesenteric plexus and other neurons

d) All of the above

013. Most tissue histamine is sequestered and bound in:

a) Granules in mast cells or basophils

b) Cell bodies of histaminergic neurons

c) Enterochromaffin-like cell of the fondus of the stomach

d) All of the above

014. These categories of histamine H1 antagonists are noted for sedative effects, EXCEPT:

a) Piperidines; i.e. Loratadine, Fexofenadine

b) Ethanolamines (aminoalkyl ethers); i.e. Dimedrol, Clistin

c) Ethylenediamines; i.e. Suprastine

d) Phenothiazines; i.e. Diprazine, Promethazine

015. Which category of histamine H1 antagonists is noted for the best antiemetic action?

a) Alkylamines (propylamines); i.e. Brompheniramine

b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine

c) Piperazines; i.e. Hydroxyzine, Cyclizine

d) Ethylenediamines; i.e. Suprastine

016. These categories of histamine H1 antagonists are noted for the anticholinergic effect, EXCEPT:

a) Alkylamines (propylamines); i.e. Brompheniramine

b) Piperazines; i.e. Hydroxyzine, Cyclizine

c) Ethylenediamines; i.e. Suprastine

d) Phenothiazines; i.e. Diprazine, Promethazine

017. Which category of histamine H1 antagonists is noted for the alpha-adrenoreceptor-blocking effect?

a) Alkylamines (propylamines); i.e. Brompheniramine

b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine, Dimedrol

c) Ethylenediamines; i.e. Suprastine

d) Phenothiazines; i.e. Diprazine, Promethazine

018. Which category of histamine H1 antagonists is noted for the highest local anesthetic effect?

a) Alkylamines (propylamines); i.e. Brompheniramine

b) Piperidines; i.e. Loratadine, Fexofenadine

c) Ethylenediamines; i.e. Suprastine

d) Phenothiazines; i.e. Promethazine

019. Which category of histamine H1 antagonists is recognized for as second-generation antihistamines?

a) Alkylamines (propylamines); i.e. Brompheniramine

b) Piperidines; i.e. Loratadine, Fexofenadine

c) Ethylenediamines; i.e. Suprastine

d) Phenothiazines; i.e. Promethazine

020. These histamine H1 antagonists are recognized for as second-generation antihistamines, EXCEPT:

a) Astemizole

b) Loratadine (Claritin)

c) Cetirizine (Zyrtec)

d) Suprastine

021. Which of histamine H1 antagonists is noted for the serotonin-blocking effect?

a) Brompheniramine

b) Cyproheptadine

c) Suprastine

d) Dimedrol

022. Which of the following histamine H1 antagonists is a long-acting (up to 24-48 h) antihistamine drug?

a) Diazoline

b) Diprazine

c) Suprastine

d) Dimedrol

023. Which of histamine H1 antagonists is noted for the ulcerogenic effect?

a) Diazoline

b) Loratadine

c) Suprastine

d) Dimedrol

024. Indication for administration of histamine H1 antagonists is:

a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)

b) Motion sickness and vestibular disturbances

c) Nausea and vomiting in pregnancy (“morning sickness”)

d) All of the above

025. Indications for administration of histamine H1 antagonists are the following EXCEPT:

a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)

b) Management of seizure states

c) Nausea and vomiting in pregnancy (“morning sickness”)

d) Treatment of sleep disorders

026. Side effect of first-generation histamine H1 antagonists is:

a) Aplastic anemia

b) Vomiting, tinnitus, decreased hearing

c) Sedation

d) Gastric ulcers and upper gastrointestinal bleeding

027. For those first-generation histamine H1 antagonists that cause significant sedation, addition of other drugs that cause central nervous system depression produces additive effects and is contraindicated while driving or operating machinery. This consideration is:

a) True

b) False

028. Immunosuppressive drug is any of a variety of substances used to prevent production of antibodies, protein produced by the immune system in response to the presence in the body of antigens: foreign proteins or polysaccharides such as bacteria, bacterial toxins, viruses, or other cells or proteins. This consideration is:

a) True

b) False

029. Immunosupressive effect of glucocorticoids is caused by

a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and other antigen-presenting cells

b) Suppression of cyclooxygenase II expression that results in reducing amount of an enzyme available to produce prostoglandins

c) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis

d) All of the above

030. Antiallergic effect of glucocorticoids is caused by:

a) Suppression of leukocyte migration and stabilizing lysosomal membranes

b) Reverse the capillary permeability associated with histamine release

c) Suppression of the immune response by inhibiting antibody synthesis

d) All of the above

031. The Immunosuppressive agent is:

a) Corticosteroids

b) Cyclosporine

c) Tacrolimus (FK 506)

d) All of the above

032. Class of cyclosporine A is:

a) Interferons

b) Immunosuppressive agents

c) Monoclonal antibodies

d) Immunoglobulins

033. Mechanism of action of cyclosporine A is:

a) Complement-mediated cytolysis of T lymphocytes

b) ADCC towards T lymphocytes

c) Inhibits calcineurin

d) Compete for Fc receptors with autoantibodies

034. Side effect of cyclosporine A is:

a) Tremor

b) GI disturbance

c) Hepatotoxicity

d) All of the above

035. Side effect of cyclosporine A is:

a) Tremor

b) Anorexia

c) Chills

d) Myalgia

036. Side effect of cyclosporine A is:

a) Diarrhea

b) Headache

c) GI disturbance

d) Immunosuppression

037. Indication of cyclosporine A is:

a) Secondary immunodeficiency

b) Hairy cell leukemia

c) Primary immunodeficiency

d) Idiopathic nephrotic syndrome

038. Half-life of cyclosporine A is:

a) 25-35 minutes

b) 21 days

c) 4 - 16 hours

d) 19 hours

039. Class of I.V. IgG preparation is:

a) Monoclonal antibodies

b) Immunosuppressive agents

c) Interferons

d) Immunoglobulins

040. Mechanism of action of I.V. IgG preparation is:

a) Inhibits CD3 receptor

b) Inhibits calcineurin

c) Complement-mediated cytolysis of T lymphocytes

d) Compete for Fc receptors with autoantibodies

041. Half-life of I.V. IgG preparation is:

a) 25-35 minutes

b) 19 hours

c) 4 - 16 hours

d) 21 days

042. Indication for I.V. IgG preparation administration is:

a) Kaposi's sarcoma

b) Acute rejection of organ transplant

c) Condyloma acuminatum

d) Prophylaxis of certain infections

043. Cytotoxic agents are the following EXCEPT:

a) Azathioprine

b) Cyclosporine

c) Leflunomide

d) Cyclophosphamide

044. Class of sirolimus (rapamycin) is:

a) Immunoglobulins

b) Interferons

c) Immunosuppressive agents

d) Monoclonal antibodies

045. Mechanism of action of sirolimus (rapamycin) is:

a) Anti-idiotype antibodies against autoantibodies

b) Modulation of CD3 receptor from the cell surface

c) Inhibits calcineurin

d) ADCC towards T lymphocytes

046. Monoclonal antibodies is:

a) Trastuzumab

b) Rituximab

c) OKT-3

d) All of the above

047. Class of OKT-3 is:

a) Immunosuppressive agents

b) Monoclonal antibodies

c) Interferons

d) Immunoglobulins

048. Half-life of OKT-3 is:

a) 18-24 hours

b) 25-35 minutes

c) 4 - 16 hours

d) 21 days

049. The indication for interferon gamma administration is:

a) Idiopathic nephrotic syndrome

b) Hepatitis C virus infection

c) Chronic granulomatous disease

d) Hairy cell leukemia

050. The side effect of interferon gamma is:

a) Hypertension

b) Pulmonary edema

c) Nephrotoxicity

d) Fatigue

051. Half-life of interferon gamma is:

a) 21 days

b) 19 hours

c) 4 - 16 hours

d) 25-35 minutes

052. Half-life of interferon alpha is:

a) 18-24 hours

b) 4-16 hours

c) 25-35 minutes

d) 21 days

053. The indication for interferon alpha administration is:

a) Hepatitis C virus infection

b) Kaposi's sarcoma

c) Condyloma acuminatum

d) All of the above

054. Indication for interferon alpha administration is:

a) Autoimmune diseases

b) Rheumatoid arthritis

c) Organ transplantation

d) Hepatitis C virus infection

055. Indication for interferon alpha administration is:

a) Prophylaxis of sensitization by Rh antigen

b) Rheumatoid arthritis

c) Kaposi's sarcoma

d) Chronic granulomatous disease

056. Class of tacrolimus (FK-506) is:

a) Immunoglobulins

b) Immunosuppressive agents

c) Interferons

d) Monoclonal antibodies

057. Mechanism of action of tacrolimus (FK-506) is:

a) Inhibits CD3 receptor

b) Complement-mediated cytolysis of T lymphocytes

c) Substitution for patient's defiecient immunoglobulins

d) Inhibits calcineurin

058. Immunomodulating agent is:

a) Sirolimus (rapamycin)

b) Levamisole

c) Tacrolimus (FK 506)

d) All of the above

059. Immunomodulating agents are the following EXEPT:

a) Cytokines

b) Levamosole

c) BCG (Bacille Calmette-Guérin)

d) Tacrolimus (FK-506)

060. Mechanism of action of levamisole is:

a) Inhibits CD3 receptor

b) Complement-mediated cytolysis of T lymphocytes

c) Substitution for patient's defiecient immunoglobulins

d) Increase the number of T-cells

PART VI Vitamins, Vitamin-like Compounds, Antivitamins, Enzymes & Antienzymes

001. Vitamins are:

a) Inorganic nutrients needed in small quantities in the body

b) Organic substances needed in very large quantities in the body

c) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and activity of the body and obtained naturally from plant and animal foods

d) Products of endocrine gland secretion

002. Vitamin-like compounds are:

a) A number of compounds, whose nutritional requirements exist at specific periods of development, particularly neonatal development, and periods of rapid growth

b) Inorganic nutrients needed in small quantities in body

c) Organic substances needed in very large quantities in body

d) Products of endocrine gland secretion

003. Antivitamins are:

a) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and activity of the body and obtained naturally from plant and animal foods

b) Substances that prevent vitamins from exerting their typical metabolic effects

c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized catalysts for biochemical reactions

d) Nonprotein organic substances that usually contain a vitamin or mineral and combine with a specific apoenzyme to form an active enzyme system

004. Coenzymes are:

a) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and activity of the body and obtained naturally from plant and animal foods

b) Substances that prevent vitamins from exerting their typical metabolic effects

c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized catalysts for biochemical reactions

d) Nonprotein organic substances that usually contain a vitamin or mineral and combines with a specific apoenzyme to form an active enzyme system

005. Antienzymes are:

a) Agents, especially an inhibitory enzymes or an antibodies to enzymes, that retard, inhibit, or destroy enzymic activity

b) Substances that prevent vitamins from exerting their typical metabolic effects

c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized catalysts for biochemical reactions

d) Nonprotein organic substances that usually contain a vitamin or mineral and combines with a specific apoenzyme to form an active enzyme system

006. Hypovitaminosis is an insufficiency of one or more essential vitamins. This consideration is:

a) True

b) False

007. Hypervitaminosis is any of various abnormal conditions in which the physiological effect of a vitamin is produced to a pathological degree by excessive intake of the vitamin. This consideration is:

a) True

b) False

008. Select a fat-soluble vitamin:

a) Ascorbic acid

b) Tocopherol

c) Thiamine

d) Riboflavin

009. Select a water-soluble vitamin:

a) Vitamin A

b) Vitamin E

c) Vitamin D

d) Vitamin B1

010. Which of the following vitamins can be also synthesized from a dietary precursor?

a) Vitamin С

b) Vitamin A

c) Vitamin B1

d) Vitamin B6

011. Which of the following vitamins resembles with hormone

a) Vitamin К

b) Vitamin A

c) Vitamin D

d) Vitamin E

012. Beri-beri is caused by the deficiency of:

a) Riboflavin

b) Ascorbic acid

c) Nicotinic acid

d) Thiamine

013. Beri-beri is

a) Disease caused by a deficiency of thiamine, endemic in eastern and southern Asia, and characterized by neurological symptoms, cardiovascular abnormalities, and edema. It is also called endemic neuritis

b) Inflammation at the corners of the mouth caused by a deficiency of riboflavin, associated with a wrinkled or fissured epithelium that does not involve the mucosa

c) A disorder of the lips often due to riboflavin deficiency and other B-complex vitamin deficiencies and characterized by fissures, especially in the corners of the mouth

d) All of the above

014. Deficiency symptom of riboflavin is:

a) Cheilitis – inflammation of the lips or of a lip, with redness and the production of fissures radiating from the angles of the mouth

b) Cheilosis – a disorder of the lips characterized by fissures, especially in the corners of the mouth

c) Angular stomatitis, associated with a wrinkled or fissured epithelium that does not involve the mucosa

d) All of the above

015. All of the following statements concerning vitamin A functions are true EXCEPT:

a) Transmission of light stimuli to the brain, via combination with a specific protein, opsin, to form a visual pigment, rhodopsin, in the retina of the eye

b) Regulation of cell growth and differentiation in epithelium, connective tissues (including bone and cartilage) and hematopoietic tissues by retinoic acid, a highly bioactive metabolite of retinol

c) Retinoic acid is especially important during embryogenesis

d) Acts as a hormone involved in regulation of calcium and phosphorus homeostasis

016. Deficiency symptom of vitamin A is:

a) Night blindness – lessened ability to see in dim light

b) Xerophthalmia and keratomalacia

c) Various epithelial tissue defects, leading to decreased resistance to infective diseases, male and female infertility

d) All of the above

017. Xerophthalmia is:

a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin A

b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent ulceration and perforation of the cornea

c) A condition of the eyes in which vision is normal in daylight or other strong light but is abnormally weak or completely lost at night or in dim light and that results from vitamin A deficiency

d) All of the above

018. Keratomalacia is:

a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin

b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent ulceration and perforation of the cornea

c) A visual defect marked by the inability to see as clearly in bright light as in dim light

d) All of the above

019. Night blindness (Hemeralopia, Nyctalopia) is

a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin

b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent ulceration and perforation of the cornea

c) A condition of the eyes in which vision is normal in daylight or other strong light but is abnormally weak or completely lost at night or in dim light and that results from vitamin A deficiency

d) All of the above

020. All of the following statements concerning vitamin E functions are true, EXCEPT:

a) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable b) Antisterility and antiabortion factor

c) Specifically required for synthesis of prothrombin and several other clotting factors

d) An essential for oxidative processes regulation

021. Which of the following statements concerning vitamin B1 functions are true:

b) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of pyruvate to acetyl coenzyme A

c) Specifically required for synthesis of prothrombin and several other clotting factors

d) Essential constituent of the flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)

022. All of the following statements concerning vitamin B2 functions are true EXCEPT:

a) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)

b) Plays key roles in hydrogen transfer reactions associated with glycolysis, TCA cycle and oxidative phosphorylation

c) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of pyruvate to acetyl coenzyme A

d) Deficiency symptoms are cheilitis, cheilosis and angular stomatitis

023. Which of the following statements concerning vitamin PP (B3, niacin) functions are true:

a) Active group of the coenzymes nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine phosphate (NADP)

b) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of pyruvate to acetyl coenzyme A

c) Specifically required for synthesis of prothrombin and several other clotting factors

d) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)

024. Which of the following statements concerning pyridoxine (vitamin B6) functions are true:

a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation of amino acids in more than 50 different enzyme systems

b) Active group of the coenzymes nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine phosphate

(NADP)

c) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)

d) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable

025. Which of the following statements concerning pantothinic acid functions are true: